Another thing I love about MD Anderson is that I get to see all (by which I mean: both) my doctors on the same day. After two years of scheduling appointments with three different doctors in three different buildings, trying to get the appointments as close together as I could, but not on top of each other, in case someone went over in time... Having this one-stop shop really is fantastic.
I met with the surgeon (Dr. G) first, and his nurse. He delivered the news that my tumor hasn't grown in two months (amazing!), which means that surgery isn't imminent - by any stretch of the imagination. He recommended another scan in 3-4 months to chart the growth, and if it's grown substantially by then, we'll talk turkey about cutting me open. He gave me the news, then sort of waited for a reaction. I was absolutely shocked to hear that my tumor hasn't grown, considering the tumor I had this time last year went from dime-sized to baseball-sized in the course of 7 weeks and it's been 8 weeks since my last scan of this little guy, but told him that I was fine with waiting it out. He said, "Really? Because Dr. H (the oncologist) was pretty sure you'd fight me on not having surgery right away." "Oh, really?" I said, "He thought I would be mad that you don't want to operate right away?" He explained that Dr. H had picked up in my first consult that I wanted this thing the heck out of me and thought I'd be a little more feisty about it not coming out right away. Dr. G explained that, between the size of the tumor being so small that there's a risk of missing it if he went in to get it right now and the fact that he'd like to give my body as long of a rest as he possibly can before he cuts me open, he wants to hold off. I told him that while I don't like having a tumor in my body, I understand and support his plan. I mean, he is the surgeon. It makes sense that he'd get to call the shots here.
We talked a little about what will happen when he does operate. Of course, it's all subject to change depending on what happens inside my body between now and then, but right now the plan is to go in and take all the fatty tissue off the retroperitoneum and leave only muscle (I told him that I approved of this plan, because I will at least be all toned and fat-free on the inside). He may or may not take my left kidney. He may or may not irradiate my left kidney before he goes in. ... This was a little surprising to me, as I'd been told a year ago that radiation would be off the table for the rest of my life, because to irradiate an area that had already received radiation treatment would, in essence, cause radiation poisoning. I asked him how that would work, and whether what they told me last year was a true story or ... not so much of a true story. He explained that it was a little bit of a true story, and a little bit not a true story. It seems that there are different types and levels of radiation, and that there are some areas that can be irradiated again after a certain period of time. When we get closer to surgery, he'll review my radiation history and make a decision as to whether or not he'd recommend radiation. The upside? He'll irradiate a small area, nowhere near what my last radiation oncologist did.
The tumor itself hasn't grown, but there seems to be a new ribbon of scar tissue forming. I asked how that can happen, if scar tissue just appears months or years after the fact. He explained that it can happen. There's a chance that it's a difference in the scans themselves, that one film had a line or damage that the other didn't, but it looks like it's new scar tissue. I told him about the now almost constant cramp in my lower back and asked if could be tumor or scar tissue related. He confirmed that it's most likely scar tissue related. The stinky thing is... there isn't much I can do about it, other than try to stretch it out when it gets bad. (It's sort of charlie-horse-ish in nature. Sometimes it's a sharp pain, but usually it's more of a dull ache. I feel it more when I bend or move in certain ways, which I am now making a daily effort to avoid getting myself into.) The good news about surgery is that he'll take the tissue where the scar tissue currently is. So, this pain will only last until these scars come out. (Of course, then I could soooo have the same issue with new scars, but whatever. I'll cross that bridge when I get there.)
He confirmed that even though this will be my third surgery, he believes this is really only my second tumor. He believes that the tumor I had removed last March was actually a remnant of the first tumor that was removed in June 2010. (We'll never know for sure, but it's certainly possible that when my surgeon did the first surgery, he didn't go deep enough to get the whole thing.) Now, I had scans after my first surgery that were clean, but there could have been microscopic matter there that didn't show on those scans. When I asked how a microscopic tumor could have withstood a full 6 weeks of radiation therapy, he kind of screwed up his face and explained that (drumroll please) this type of tumor doesn't respond well to general radiation therapy. (Awesome. These damn tumors don't respond to chemo OR radiation. ... I learn this over a year after I went through the special kind of hell that is radiation to the abdomen, when I am still living with the ramifications of what said surgery did to my colon. There are not words for how frustrating it is to learn things like this. I tell you, there are not words.)
We talked for a few more minutes, I can't remember the specific details right now. He excused himself for a moment. There had been some banter as to whether there was any other reason that Dr. H had sent him in to talk to me first. Dr. G said he didn't know what I was talking about (but we all remember that he knew darn good and well that I proposed to H the last time I was there). After he left the room, the nurse asked for the backstory on what happened the last time I'd been there. I gave her a quick run down of how my first appointment had gone down, that H hadn't exactly said "no", but that there'd been talk of cookies in his decision-making process. She laughed her fool head off. When Dr. G came back in, he let us know that Dr. H would be with us in a few minutes and he and his nurse headed off to surgery.
About five minutes later, a new nurse came in. She said that she wanted to introduce herself to me, since I hadn't met her the last time I was there. We chatted for a few minutes and she asked if I had plans for Dr. H. I wasn't sure what she meant, and told her so. ... She admitted that the first nurse had come out of the room laughing and told her that she needed to come in and ask me for the story about Dr. H. I related the story of my first visit and held up my tupperware full of sugar cookies to show her that I'd brought him a little prize. She laughed. She clapped. She proclaimed us "perfect for each other".
I love her.
As she was leaving, Dr. H came in and took a seat. He asked how I'm feeling. I was honest, in that I'm feeling pretty good these days, much better than I was a month ago. I told him that I've been sleeping better (this is true). I'd been planning on asking for sleeping pills the next time I saw him, up until about two weeks ago when I started sleeping through the night without any drugs or anything. (Yay going on walks! Also, yay for getting just a little bit more of a grip on what's going on. The first 4-6 weeks were absolute hell on my diet and sleep patterns. The emotional roller coaster of chemo/not chemo, surgery/not surgery has been crazy, but I seem to have leveled out a bit.) He asked if I'd be interested in meeting with the staff psychologist. I said "Sure!". I think my enthusiasm took him by surprise. (My guess is not everyone welcomes getting shrinked the way that I do. As much as I do love drugs - and I do love them, we all know how I feel about the Ativan - I also love talking to someone who can help me figure myself out and use words to come to terms with things.)
We talked about the plan of not having surgery for a while. I asked him why he'd told G that he had to go first. He just laughed and said that he didn't think I'd like that plan and didn't want to be the one to have to break it to me. I told him that I was right, I didn't really like the plan. But you know what? I don't really like having a tumor. Period. There is no plan that I do like. Surgery done too soon, with a possible miss of a tumor? This does not sound good. (Surgery at all doesn't sound fun - I've done it before and it's horrible - but surgery for no good reason? Uhhhh.... No.) Chemo that will for sure make me sick and only maybe kill a tumor? This also does not sound good. Again, there is no plan that I like, but this is a plan that I can live with.
We chatted for a few minutes. He asked how I'm doing, over here on Dobson. (Last time I was there, he asked what part of town I lived in. When I gave him my cross roads, he told me that he goes to the gym over here, and then he kind of winced and said "that doesn't seem like a very nice part of town". ... Gotta love the foreigners. They don't mince words. ... I confirmed that it isn't actually a very nice part of town, but that as long as I don't go on walks after dark, I'm okay. I had told him that his gym was probably safe, but I'd recommend staying away from the WalMart over there after 10:00 PM, because for some reason, that seems to be the magical hour when it goes from a low-cost grocery super center to a hang-out for creepers extraordinaire.) ... Anyway, I'd warned him about the WalMart the last time I'd seen him, and he told me that he thought about me during the last month, when he was going to the gym, esp at night - and that he'd stayed away from the WalMart.
*He thinks about me.* Color me giddy.
We joked a little about WalMart and Mormons and our attraction to all things cheap. He was shocked "I didn't know Mormons are cheap!". Oh, yes. Yes, we are. Out of the mouths of two more witnesses, Jo and I told him that we are a people who are known for looking for a bargain. (I explained that it comes of usually having large families.) ... And speaking of families and marriage and such things.... I asked him if he remembered our deal from my first visit. He raised an eyebrow and asked "What deal?" I reminded him, "I asked you to marry me and you laughed in my face..." Which, of course, caused him to start laughing all over again. "That's still not a 'no'", I said, "and besides, I brought you a prize". He got all excited, both eyebrows shot up, as he said "You did?! Where is it?!" I leaned over and picked up the tupperware wrapped in a plastic bag that had been sitting to the side of my chair and handed it over to him. "As promised, cookies to help you make a decision." He took the container out of the bag and laughed out loud. "Are they all hearts?", he asked. "Yup", I proudly answered. "You're sure? You didn't put any dogs or cats in there in the middle?" Then I laughed out loud and Jo said "You'd better know she would have, if she'd thought of it!". ... He thanked me for his prize, smiling like a cheshire cat. It turns out this is the first prize/baked good that anyone's brought him since he started working in Arizona. (I'm shocked. I really thought some of his other Mormon patients - he told me he has a lot of them - would have brought him something. We are, after all, a baking people. ... Maybe they're all married and aren't trying to con him into paying for their lives. That's the only explanation I can think of.) He asked if all the ingredients had come from WalMart. I winked and said "Most of them, but some of it's from Costco - where the food's even cheaper!"
We had a good laugh. He thanked me profusely. ... He didn't say yes, but then, he didn't try a cookie in my presence either. (I'm telling you, they're good. I'm pretty sure he'll feel compelled to marry me once he's tasted the cookies. And no, I didn't put any love potion in them. Just butter.) As he was leaving the room, he confirmed that he'll set up the appointment with the psychologist in two weeks. I won't see Dr. G until most likely June, when my next round of scans are scheduled, but he told me to call and set something up with him if anything came up in the meantime. (It was all I could do not to tell him that the phone works both ways, you know. ... It's tricky, this flirting with your doctor business. I mean, I so am not kidding about my offer to let him marry me and pay for my life - but I don't want to scare him off, or worse, do something that would make him file a restraining order.)
After he left the room, the nurse came back in, winked and me and told me, again, that we'd be perfect together. She'd seen him come out holding a box full of cookies and said he looked so happy. (I was just bummed that I hadn't thought of putting any dogs or cats in there. You know I have those cookie cutters and it's killing me that he beat me to a punchline.)
I love having the support of the nursing staff in my quest to make my oncologist love me.
Also, I love that my tumor hasn't grown. (There was a .2 centimeter difference between the scan done Jan 3 and the scan on Mar 8. That's about the equivalent of the ridge on the outside of a dime. So, it's nothing.) I'm stunned that it's stayed the same size. I mean, stunned. And super, duper grateful. The longer I can keep this puppy in me, the better I can heal from my last surgeries. Also, the closer I get to my 1 year work anniversary, the better. I started a new job in September and will qualify for a medical leave after one year of employment. If I can hold off on surgery until the fall, I'll be in SUCH a better situation - and I'm starting to think that could really happen. I am, as always, amazed that, even in a crappy situation, things work out to be not so bad. (Oh, and Dr. H's pants were a little too tight. That's adorable, and gives me hope that he will actually love me for my cookies. Since I know he's a gym-goer, I'd had some concerns, but too-tight pants bring me hope.)
